Provider Demographics
NPI:1104134212
Name:BELL, ELIZABETH S
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:S
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1778 OAKLAND RD APT 35
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-3569
Mailing Address - Country:US
Mailing Address - Phone:408-401-2887
Mailing Address - Fax:
Practice Address - Street 1:1778 OAKLAND RD
Practice Address - Street 2:35
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-3567
Practice Address - Country:US
Practice Address - Phone:408-401-2887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health